CHICA Audit Toolkit

www.chica.org

The Audit Process

Acknowledgements

CHICA-CANADA Audit Toolkit Working Group members:

• Anne Bialachowski• Karen Clinker• Mary LeBlanc• Shirley McDonald

Benefits of CHICA Membership

CHICA-CANADA membership with its protected password:

http://www.chica.org• provides free access to all of the on-line and

interactive audit tools as they are developed, as a privilege of membership (not available to non-members)

• promotes interest in CHICA membership

Benefits of CHICA Membership

Objectives

To describe key steps in the auditing process

To provide a brief overview of the CHICA Audit toolkit

Audit Process Steps

The steps in carrying out a successful audit include: 1. Prepare for the

audit

Pre-audit PreparationSelect a prepared

auditor and area to be audited:• auditor must be

objective• must understand the

audit tool• must have the ability to

observe and assess practice

• can be an ICP and/or department staff

Pre-audit PreparationEstablish the audit

methodology:• who are the

stakeholders (who gets the report)?

• establish scope of audit (e.g., all staff vs. some staff; all rooms on a unit vs. patient rooms)

• how is audit to be conducted (e.g., PDA vs. paper, time period)

Pre-audit PreparationSelect the criteria to be

audited:• evaluate against

standards of practice• design data collection

tool• validate audit tool

OR• use CHICA’s audit tools!

Pre-audit PreparationUtilize current best

practices and standards:• CSA standards• provincial regulations

(e.g., OHS)• national guidelines (e.g.,

PHAC• provincial best practices

(e.g., PIDAC)• International guidelines

(e.g., WHO, CDC)• published literature

Audit Process Steps

The steps in carrying out a successful audit include: 2. Conduct the audit

by observing practice

Audit Process Steps

The steps in carrying out a successful audit include: 3. Post-audit follow

up and feedback

Post-auditThe Audit Summary Report

Post-audit Analysis• Using the Impact

Definitions (blue), determine which best describes the seriousness of the deficiency

• Using the Likelihood Definitions (yellow), determine which best describes the likelihood of the deficiency occurring in future if not dealt with now

Post-audit AnalysisDetermine Risk Level

Post-audit Analysis After determining the Risk Level of the

deficiency, you (and stakeholders) are ready to look at:• recommended corrective action(s)

• level of involvement

• action timeline for resolution

Use the Risk Level Chart to assist you with action planning decisions

Post-audit AnalysisRisk Level Chart

Audit Process Steps

The steps in carrying out a successful audit include:

4. Re-audit to “close

the loop”

Questions ?

Thank you!